In 2018, the World Health Organization identified cancer as one of the major causes of death worldwide which is responsible for the deaths of 9.6 million people in 2018 (1, 2). In Iran, according to the statistics of the Global Cancer Observatory (GCO), the International Cancer Research Agency of the World Health Organization, 79,136 people have died by 2020. Most tumour treatment include a combination of surgery, chemotherapy, or radiation therapy. However, there are various challenges in classical chemotherapy, including harmful side effects (3–6) Therefore, in the last decade, new methods have emerged in the treatment of cancer; among them are treatments according to the histological sub-group and influence micro-tumours (7). One of the alternative methods of tumour treatment is treatment through the vascular system based on the increase in tumour size must be coordinated with the increase in blood supply (8). Proliferating tumours, due to the increase in the distance between cells and vessels, the need for oxygen and the supply of oxygen in them have exceeded, which prevents the diffusion of oxygen and creates a more hypoxic environment (9, 10). New blood vessels increase the amount of oxygen and the nutrients needed based on the cell volume bring the cancer mass to the tumour cells and most importantly, they facilitate the metastasis of cancer cells to other places (11). Accordingly, angiogenesis, by supplying oxygen, nutrients, growth factors, proteolytic enzymes, coagulation factors, and fibrinolytic factors support tumour growth (12). Folkman et al. (1971) identified the main factors effective in tumour angiogenesis, and by inhibiting those factors, were able to use the strategy of tumour starvation and its death in the treatment of the disease (13–17). In the last 10 years, many potential anti-angiogenic targets had discovered with successive discovery of factors such as fibroblast growth factor, matrix metalloproteinase, tumour-related stromal cells and adhesion molecules (18).
Vascular endothelial growth factor (VEGF):
VEGFs play a key role in the regulation of angiogenesis (19, 20). Scientists have stated that the regulation of VEGF levels caused by hypoxia is the main driving force of angiogenesis in the path of tumour progression. VEGF increases vascular permeability and cause the increase in vascular permeability leads to the release of plasma proteins and their entry into the interstitial space, which leads to the migration and proliferation of endothelial and angiogenic cells (21). VEGF family includes subtypes VEGFC, VEGFB, VEGFA, VEGFF, VEGFE, VEGFD and placental growth factor (22), but it is thought that VEGFA is the key regulator of angiogenesis during homeostasis and disease. VEGFA increases the secretion of matrix metalloproteinase (MMP) and proliferation of endothelial cells. VEGFC and VEGFD are key lymphangiogenic factors during development (23). VEGFE, which is structurally almost identical to VEGFA. Another family member, VEGFB, does not appear to display angiogenic activity, but is a key regulator of fatty acid metabolism (14, 24).
Angiopoietins (Angs):
The family of angiopoietin (Ang) is an angiogenic stimulating factor, including Ang-1, Ang-2, Ang-3 and Ang-4. These molecules bind to an endothelial receptor tyrosine kinase, Tie-2, to promote angiogenesis. Angs control the homeostasis of endothelial cells by modulating maturation and vascular stability and cell survival (25). VEGFs are activated in the early stages of angiogenesis, while Ang/Tie-2 systems are activated in the later stages, control vessel assembly, and maturation of the fatal vascular system as well as vascular homeostasis of the adult vascular system. Ang-2 acts with VEGF to initiate angiogenesis. In addition, platelet-derived growth factor (PDGF) and TGF-β other angiogenic factors stabilize new vessels. One of the main ways to reduce angiogenesis in tumour tissue is the use of food and supplements food. Notably, several components of natural resources have been reported to have anticancer activities on cancer cells through different mechanisms, including induction of apoptosis and necrosis and inhibition Angiogenesis is possible (26, 27). Since Angiogenesis plays a prominent role in tumour growth and metastasis, inhibition of angiogenesis is considered as an important strategy for cancer treatment (14). In addition, inhibition of angiogenesis before initiation, which is known as angioma prevention, has the potential to prevent the spread of hyperplastic foci and subsequent tumour development in the premalignant stage (21). Salvia officinalis S. officinalis (Fig. 1) is one of the largest genera of the Lamiaceae family, a perennial herb that can grow about 30 to 60 cm. Several species produce woody stems and grow more like a shrub (26). Based on the ability of this plant to grow in different geographical areas, this plant can be identified in regions with different climates (28–31). All over the world, this species is used in traditional medicine as antibacterial, antioxidant, anti-diabetic, anti-tumour, herbal tea and food seasoning (32). Salvia plant essential oils exhibit broad-spectrum pharmacological activities and represent great interest for food preservation as potential natural products (33). The phenolic compounds of methanolic extracts of Salvia pomifera and Salvia fruticosa were identified by liquid chromatography tandem mass spectrometry. Carnosic acid and its metabolite carnosol were the most abundant terpene phenolic compounds of S. fruticosa, while they were completely absent in S. pomifera (34).
The analysis of the hydroalcoholic extract of S. Officinalis showed it contain various flavonoids and phenolic compounds (35–38). The most important flavonoids include quercetin, kaempferol, luteolin (soluble in water), luteolin-7-glucoside, apigenin-7-glucoside, myristin and murine with strong antioxidant activity. They are analgesic and anti-inflammatory, in addition, it contains various other compounds such as steroids, saponins, tannins, phenols and polypeptides, carnosol, rosmarinic acid, and camosic acid (39–43). In recent years, the potential use of Salvia as a new anticancer agent has been recognized. Therefore, in this article, the anticancer property of phytochemicals is investigated.